Inflammatory Bowel Disease in Children

About Inflammatory Bowel Disease

Inflammatory bowel disease refers to two chronic (or recurring) conditions called “Crohn’s disease” and “ulcerative colitis,” which cause redness and swelling (inflammation) in parts of the intestinal tract. Like asthma, IBD symptoms in children occur in bouts — periodically flaring up for sometimes weeks or months.

What’s the Difference Between IBS and IBD?

Often confused with irritable bowel syndrome (IBS), IBD is a condition that can cause the intestines to narrow and restrict food from moving through the bowel. IBS is a functional disorder, which means the digestive system looks perfectly normal, but it doesn’t work exactly like it should. IBD and IBS have many similar symptoms, but IBS doesn’t cause blood in the stool (bowel movements or poop) like IBD can.

Crohn’s vs. Ulcerative Colitis in Children

Crohn’s disease and ulcerative colitis are both inflammatory bowel diseases that cause inflammation to different parts of the digestive system. Crohn’s can occur anywhere along the intestinal tract, but it’s commonly found in the last segment of the small intestine (ileum) and the large intestine (colon). Ulcerative colitis mostly affects the colon.

Crohn’s impacts the entire thickness of the intestine and can affect more than one section of the intestinal tract. In contrast, ulcerative colitis occurs only within the inner lining of the organ and is found only in one spot.

What Causes IBD in Children?

The exact cause of IBD in children is unknown. However, experts agree that the environment, genetics, and/or diet may have something to do with it. Scientists believe that an overactive immune system may trigger inflammation in response to an offending agent, like a virus or certain foods. Researchers are actively studying IBD to get to the bottom of possible causes, and hopefully help relieve IBD symptoms in children and adults.

Constipation

Constipation is a very common problem in kids. A child is considered constipated when he or she has fewer than three bowel movements in a week; has trouble having a bowel movement; or when the stool (poop) is hard, dry, and unusually large.

Constipation usually isn't a cause for concern, and easy to avoid by adopting healthy eating and exercise habits.

Causes of Constipation

Constipation usually is due to a diet that doesn't include enough water and fiber, which help the bowels move properly. Kids who eat lots of processed foods, cheeses, white bread and bagels, and meats may become constipated fairly often. Eating a healthier diet with high-fiber foods like fruits, vegetables, and whole grains can keep stool from getting hard and dry.

Sometimes, medicines like antidepressants and those used to treat iron deficiencies can cause constipation. Constipation can happen in babies as they move from breast milk to baby formula, or from baby food to solid food. Toddlers who are toilet training sometimes can become constipated, especially if they're pushed to toilet train before they're ready.

Some kids avoid going to the bathroom, even when they really have the urge to go. They might ignore internal urges because they don't want to use a restroom away from home, stop playing a fun game, or have to ask an adult to be excused to go to the bathroom. Ignoring the urge to go makes it harder to go later.

Stress also can lead to constipation. Kids can get constipated when they're anxious about something, like starting at a new school or problems at home. Research has shown that emotional upsets can affect how well the gut functions and can cause constipation and other conditions, like diarrhea.

Some kids get constipated because of irritable bowel syndrome (IBS), which can happen when they're stressed or eat certain trigger foods, which often are fatty or spicy. A child with IBS may have either constipation or diarrhea, as well as stomach pain and gas.

In rare cases, constipation is a sign of other medical illnesses. So talk to your doctor if your child continues to have problems or if the constipation lasts for 2 to 3 weeks.

Symptoms of Constipation

Keep in mind that different kids have different bathroom habits. A child who doesn't have a bowel movement every day isn't necessarily constipated. One child might go three times a day, while another might go once every 3 days.

Generally, signs of constipation in kids include:

going less than usual

having trouble or pain when going to the bathroom

feeling full or bloated

straining to poop

seeing a little blood on the toilet paper

It's also common for kids with constipation to sometimes stain their underwear with bits of stool.

Dealing With Constipation

To prevent and treat constipation:

Give your child more fluids. Drinking enough water and other liquids helps stools move more easily through the intestines. The amount of fluids kids need will vary according to weight and age. But most school-age kids need at least 3 to 4 glasses of water each day. If your infant is constipated during the move from breast milk or to solid foods, try serving just a few ounces of prune juice each day. If the constipation lasts or is upsetting your child, it may be due to a health problem, so call your doctor.

Serve more fiber. High-fiber foods (such as fruits, vegetables, and whole-grain bread) can help prevent constipation. Fiber can't be digested, so it helps clean out the intestines by moving the bowels along. A diet full of fatty, sugary, or starchy foods can slow the bowels down. When adding more fiber to your child's diet, do so slowly over a few weeks and make sure your child also drinks more fluids.

Fiber doesn't have to be a turn-off for kids — try apples, pears, beans, oatmeal, oranges, ripe bananas, whole-grains breads, and popcorn. Adding flax meal or bran to homemade fruit smoothies is another way to slip fiber into a child's diet.

Make sure kids get enough exercise. Physical activity nudges the bowels into action, so encourage your kids to get plenty of exercise. It can be as simple as playing catch, riding bikes, or shooting a few hoops.

Develop a regular meal schedule. Since eating is a natural stimulant for the bowels, regular meals may help kids develop routine bowel habits. If necessary, schedule breakfast a little earlier to give your child a chance for a relaxed visit to the bathroom before school.

Get kids into the habit of going. If your child fights the urge to go to the bathroom, have him or her sit on the toilet for at least 10 minutes at about the same time each day (ideally, after a meal).

These small changes help most kids feel better and get the bowels moving the way they should. Talk with the doctor before giving your child any kind of over-the-counter medication for constipation.